Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis

Abstract

(1) Background: Stretching is known to improve range of motion (ROM), and evidence has suggested that strength training (ST) is effective too. However, it is unclear whether its efficacy is comparable to stretching. The goal was to systematically review and meta-analyze randomized controlled trials (RCTs) assessing the effects of ST and stretching on ROM (INPLASY 10.37766/inplasy2020.9.0098). (2) Methods: Cochrane Library, EBSCO, PubMed, Scielo, Scopus, and Web of Science were consulted in October 2020 and updated in March 2021, followed by search within reference lists and expert suggestions (no constraints on language or year). Eligibility criteria: (P) Humans of any condition; (I) ST interventions; (C) stretching (O) ROM; (S) supervised RCTs. (3) Results: Eleven articles (n = 452 participants) were included. Pooled data showed no differences between ST and stretching on ROM (ES = −0.22; 95% CI = −0.55 to 0.12; p = 0.206). Sub-group analyses based on risk of bias, active vs. passive ROM, and movement-per-joint analyses showed no between-protocol differences in ROM gains. (4) Conclusions: ST and stretching were not different in their effects on ROM, but the studies were highly heterogeneous in terms of design, protocols and populations, and so further research is warranted. However, the qualitative effects of all the studies were quite homogeneous.

Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

“…However, the small number of available studies and their heterogeneity results in lack of confidence in this statement. The findings suggest that implementation of unimodal ST might be a time-efficient strategy to prevent falls in older adults, and the lack of superiority of multimodal programs in comparison with ST may result from ST alone producing multi-systemic effects, as was previously established [ 20 , 21 ]. It is interesting that no differences between programs were detectable for several secondary outcomes, including strength levels.…”

“…Muscle strength is a major factor influencing risk of falling [ 14 , 15 ], and strength-based exercise is recommended for all age groups [ 16 ], including older adults [ 17 , 18 , 19 ]. A recent review highlighted the multi-systemic benefits of ST, ranging from better bone health to positive effects on cancer and depression, to improved sleep [ 20 ], and a meta-analysis showed that ST is not inferior to stretching in improving range of motion [ 21 ]. Beyond improving strength levels and muscle hypertrophy in older adults [ 22 , 23 ], ST also improves muscle endurance [ 24 ], aerobic capacity [ 25 , 26 ], balance [ 27 , 28 ], power [ 25 ] and range of motion [ 29 , 30 ] in these populations.…”

Time to Move From Mandatory Stretching? We Need to Differentiate “Can I?” From “Do I Have To?”

“…Stretching can chronically improve ROM (Blazevich, 2018) by increasing fascicle length, improving stretch tolerance, altering pennation angles and reducing tonic reflex activity (Guissard and Duchateau, 2004;Blazevich et al, 2014), but it is not the only method capable of doing so (Saraiva et al, 2014;Afonso et al, 2021b). Stretching may be required for sports that demand extreme ROM, but for most sports and general population, there are alternative interventions available, such as resistance training (Saraiva et al, 2014;Nuzzo, 2020) and foam rolling exercises (Aune et al, 2019).…”

“…Stretching may be required for sports that demand extreme ROM, but for most sports and general population, there are alternative interventions available, such as resistance training (Saraiva et al, 2014;Nuzzo, 2020) and foam rolling exercises (Aune et al, 2019). A systematic review with meta-analysis of 11 RCTs comparing strength training to stretching for ROM gains has found that for interventions lasting 5 and 16 weeks, the strength training and stretching protocols did not differ in their effects on ROM (Afonso et al, 2021b). To different degrees, eccentric and concentric strength training with full ROM, as well as plyometric training, induce changes in muscle fascicle length and pennation angle, and tendon extensibility, resulting in ROM gains (Reeves et al, 2009;Kubo et al, 2017;Valamatos et al, 2018;Gérard et al, 2020;Marušič et al, 2020).…”

“…To different degrees, eccentric and concentric strength training with full ROM, as well as plyometric training, induce changes in muscle fascicle length and pennation angle, and tendon extensibility, resulting in ROM gains (Reeves et al, 2009;Kubo et al, 2017;Valamatos et al, 2018;Gérard et al, 2020;Marušič et al, 2020). However, the studies included in the review of Afonso et al (2021b) had considerable heterogeneity in design, populations and protocols. The answer to the question "Can I stretch to improve ROM?"…”